Architecture Design of Cloud-Base Clinical Decision Supported CPOE for Smart Devices

Abstract

“Health is wealth” a well renowned quote cum reality. Good health is a very basic need for humans, so to maintain good health our health care systems should be state of the art and in parallel with emerging technologies. As we are living in the era of automation, so it has become the necessity that our healthcare system should be automated i-e computerized to minimize the risks and to increase the quality of health care. Because the clinicians have to do many tasks, so the risk of human error increases as ‘‘Men are men; the best sometimes forget.’’. To reduce such risks now a days Clinical Decisions Support Systems (CDSS) are being used in health care in accompany with Computerized physician order entry (CPOE). DSS have reduce the risks and lapses of memory in many clinical situations. In this research our aim is to make CPOE prescribing error free, more user-friendly and more use of CPOE in hospitals. We investigated the problem that many physicians avoid using it in inpatient care due to problem of mobility (moving system bed to bed). So to overcome this hindrance in CPOE use we purposed solution for it i-e CPOE should be on portable smart devices so that it is very flexible to use by physicians in inpatient care as well as outpatient. In this study we purposed the cloud base architecture of CPOE for smart devices integrated with CDSS. In this investigation, two kinds of CDSS assessed, drug-drug interaction and drug allergy interaction which are the most commonly used and roots many prescribing error. We examined the architecture of CPOE including the interface, quality attributes, multi-lingual capacity, security and privacy. On the basis of this analysis we decided to make our CPOE system cloud base as it can be easily availed by the hospitals systems using SaaS and smart devices can be use it as MBaaS. We will use a multi-tenant databases for our CPOE on cloud. To implement our purposed architecture we made a prototype using android and for this we create the Order Sets for Urology department of DHQ Hospital Faisalabad. This implementation was done in software engineering context, followed software development life cycle process. We evaluated the purposed approach by using a mix methodology of control experiment and action research to identify observations of physicians about the designed CPOE system for smart devices. The empirical results showed the significant improvements in physician’s satisfaction. This cloud-based CPOE along with CDSS will encourage hospitals and physicians to adopt CPOE with very less operational and maintenance cost to improve the healthcare facilities.